PD19-06 ALCOHOL INTAKE INCREASES HIGH-GRADE PROSTATE CANCER RISK AMONG MEN TAKING DUTASTERIDE IN THE REDUCE TRIAL

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening I1 Apr 2014PD19-06 ALCOHOL INTAKE INCREASES HIGH-GRADE PROSTATE CANCER RISK AMONG MEN TAKING DUTASTERIDE IN THE REDUCE TRIAL Jay Fowke, Lauren Howard, Gerald Andriole, and Stephen Freedland Jay FowkeJay Fowke More articles by this author , Lauren HowardLauren Howard More articles by this author , Gerald AndrioleGerald Andriole More articles by this author , and Stephen FreedlandStephen Freedland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1525AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Although most studies found no association between alcohol intake and prostate cancer (PC) risk, an analysis of the Prostate Cancer Prevention Trial (PCPT) found high alcohol intake significantly increased PC risk, but only among men randomized to the 5α-reductase inhibitor (5-ARI) finasteride study arm. Thus, we sought to confirm the PCPT analysis to determine if alcohol use affects PC risk among men taking the 5-ARI dutasteride. Methods REDUCE was a randomized trial to compare PC risk after administration of dutasteride (0.5 mg/day) vs. placebo. Participants had a baseline PSA between 2.5-10.0 ng/ml and a recent negative prostate biopsy. Alcohol intake was determined by baseline questionnaire, and participants underwent a prostate biopsy to determine PC status at 2 and 4 years, regardless of PSA levels. Logistic regression was used to examine the association between alcohol intake and PC risk vs. no PC. Multinomial logistic regression was used examine the associations between alcohol intake and low-grade (Gleason <7) vs. no PC or high-grade (Gleason >7) PC vs. no PC. Results were adjusted for age, race, BMI, geographic region, family history of PC, diabetes, smoking status, PSA, TRUS prostate volume, and stratified by treatment arm. Results Of 6,374 men in the analysis, 998 (16%) low-grade and 435 (7%) high-grade PC cases were detected. Approximately 25% of participants reported no alcohol consumption, 49% were moderate drinkers (1-6 drinks/week) and 26% heavy drinkers (>7 drinks/week). Heavy drinkers were younger, more likely to be white, smokers, European, had lower BMI, and were less likely to be diabetic (all p<0.01). On multivariable analysis, alcohol intake was not associated with low-grade, high-grade, or overall PC risk in the placebo arm, and was not associated with low-grade PC among men taking dutasteride. In contrast, heavy drinkers in the dutasteride arm were 30% more likely to be diagnosed with PC (p=0.047), and 86% more likely to be diagnosed with high-grade PC (p=0.01). Among alcohol abstainers, dutasteride was significantly associated with reduced risk of high-grade PC (OR=0.59, p=0.02). However, dutasteride was not associated with reduced high-grade PC risk among heavy drinkers (OR=0.99, p=0.95). Conclusions Alcohol consumption negated the overall protective association between dutasteride and high-grade prostate cancer. Physicians may wish to advise patients to eliminate alcohol when taking 5ARIs if they are concerned about prostate cancer. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e548 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jay Fowke More articles by this author Lauren Howard More articles by this author Gerald Andriole More articles by this author Stephen Freedland More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...